Myeloproliferative Neoplasms (MPNs)

Cancer specialists at Penn Medicine's Abramson Cancer Center are experts in diagnosing and treating myeloproliferative neoplasms. Our blood cancer team works together to get you through your illness and to restore a sense of balance in your life.

What Is a Myeloproliferative Neoplasm (MPN)?

Myeloproliferative neoplasms (MPNs) are blood disorders in which the bone marrow makes too many of one or more types of blood cells — white blood cells, red blood cells or platelets. Normally, our bone marrow makes the cells that circulate in our blood. It is within the bone marrow that blood stem cells (immature cells) become mature blood cells over time.

Symptoms of Myeloproliferative Disorders

Symptoms vary with each type of myeloproliferative neoplasm. Common symptoms, similar to leukemia symptoms, include but are not limited to:

  • Pale skin
  • Shortness of breath
  • Lethargy (tiredness)
  • Night sweats
  • Unexplained weight loss or loss of appetite
  • Enlarged spleen
  • Vision or hearing problems
  • Fever
  • Bruising or bleeding easily

Types of Myeloproliferative Neoplasms

The type of myeloproliferative neoplasm is based on whether too many red blood cells, white blood cells, or platelets are being made.

  • Chronic myelogenous leukemia (CML), in which immature cells that would be red blood cells, white blood cells, or platelets overtake the bone marrow and blood.
  • Essential thrombocythemia, in which too many platelets are made in the bone marrow
  • Myelofibrosis (also called primary or chronic idiopathic myelofibrosis), in which abnormal blood cells and scarring build up within the bone marrow
  • Polycythemia vera, in which too many red blood cells are formed in the bone marrow

Chronic myeloproliferative disorders sometimes can become acute leukemia, in which too many immature abnormal white blood cells are made. This is a rare event. Other, less common, myeloproliferative disorders include:

  • Chronic eosinophilic leukemia
  • Chronic neutrophilic leukemia
  • Mastocytosis
  • Myeloproliferative/myelodysplastic syndromes
  • Neoplasms with eosinophilia and abnormalities of PDGFRA, PDGFRB OR FGFR1 genes

How Are MPNs Diagnosed?

There are tests available that examine the blood and bone marrow to detect and diagnose chronic myeloproliferative neoplasms. The Penn Medicine hematopathology service is a national leader in the diagnosis of neoplastic and reactive hematologic disorders, with broad expertise in myeloproliferative neoplasms. Working closely with the clinical team, Penn hematopathologists provide integrative, state-of-the art analysis using histology and a wide array of ancillary techniques, including:

  • Medical history
  • Physical exam
  • Complete blood count (CBC)
  • Genetic sequencing
  • Peripheral blood smear
  • Flow cytometry
  • Immunohistochemistry
  • Cytogenetics
  • FISH
  • The latest molecular studies (ranging from single gene assays to next generation sequencing) to ensure the most accurate and precise diagnosis for every patient.

Treatment for Myeloproliferative Neosplasms

Many patients with myeloproliferative neoplasms do not require active treatment for a long time. For others, treatment is necessary. When specific treatment for myeloproliferative neoplasms is needed, it can include:

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